An increasing number of surgical techniques are now performed arthroscopically. One type of arthroscopic procedure reconstructs the anterior cruciate ligament (ACL) in the knee. Several ACL reconstruction techniques are described in U.S. Pat. Nos. 5,139,520, 5,306,301, and 5,769,894, incorporated herein by reference in their entirety.
When the ACL has ruptured and is nonrepairable, it can be replaced using a substitute graft harvested from the patient or from a donor. The substitute ACL graft may be a portion of a patellar tendon or a semitendinosus and/or gracilis tendon graft. Alternatively, an artificial graft formed from synthetic materials or from a combination of artificial and natural materials may be used and is sometimes referred to as a ligament augmentation device (LAD). The term “tissue graft” is used herein to encompass all of these tissue replacements.
In general, the replacement tissue graft is placed within a passage formed within the femur and a passage formed in the tibia, and secured to the femur and tibia.